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ARCHIVED REPORTS_XR0002367
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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15
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3500 - Local Oversight Program
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PR0545195
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ARCHIVED REPORTS_XR0002367
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Entry Properties
Last modified
1/23/2020 3:34:23 PM
Creation date
1/23/2020 2:50:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002367
RECORD_ID
PR0545195
PE
3528
FACILITY_ID
FA0002915
FACILITY_NAME
TRACY MARKET INC
STREET_NUMBER
15
Direction
E
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
21435004
CURRENT_STATUS
02
SITE_LOCATION
15 E GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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{ <br /> Ar on Laboratories Sample Recei t Checklist <br /> Client Name: <br /> Date&Time Received: ] <br /> project tJame: EQf r: n 3 �f- /2 <br /> .' �/ Client Project Number:t <br /> Recelvedi3y: Matrix: Water �J Sail ❑ Other <br /> Sample Carrier: Client (Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: 96 <br /> Shipper Container in good condition? Sufficient sample volume for requested lests?Yes t=i No ❑�' <br /> N/A [� Yes ❑ No <br /> ❑ Samples received within holding time? Yes No ❑ <br /> I Sarnples received under refrigeration? Yes No <br /> u ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes No ❑ <br /> Chain of custody present? Yes No ❑ VOA vials with preservative? <br /> ` N/A ❑ Yes [� Na <br /> Chain of Custody signed by all parties? Yes No ❑ VOA vials preservative type: <br /> ,i <br /> HCl_ [� Na2S2CJ ❑ Other <br /> Chain of CLslody matches all sample[abels? Do VOA vials contain zero headspace? <br /> Yes No ❑ NIA ❑ YesNo <br /> t Sampies received in proper containers? Yes —/ No <br /> L] Samples received intact? Yes VNo �.i � <br /> �I <br /> i g ; ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> is <br /> F <br /> Action Taken; <br /> Ei <br /> ADDITIONAL.TEST(S)REQUEST!OTHER <br /> h Contacted.By: Date: Time: <br /> 4 Call Received By: <br /> :i <br /> Comments: <br /> 1 <br /> v.5.02 <br /> I <br />
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